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General NPI Number Information
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NPI Number | 1427652130
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Entity Type | Individual
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Provider Name | ADEBOLA A KOKO FNP
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Gender | Female
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Dates
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Enumeration Date | 11/23/2020
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Last Update Date | 07/07/2023
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Provider Practice Location Address
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Address Line | 43875 WASHINGTON ST STE C
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City | PALM DESERT
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State | CA
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Zip | 92211-8249
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Country | US
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Telephone | 833-935-6377
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Fax | 833-935-6377
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Provider Business Mailing Address
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Address Line | 23851 ALBERS ST
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City | WOODLAND HILLS
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State | CA
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Zip | 91367-5809
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Country | US
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Telephone | 833-935-6377
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Fax | 833-935-6377
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95016000
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License Number State | CA
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